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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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Dr KK Aggarwal

From the Desk of Editor in Chief
Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Member Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR


10th May, Monday, 2010

Hypertension Plus Tachycardia Equals High Risk

Dear Colleague

A high resting heart rate is associated with an increased risk of cardiac events in high-risk hypertensives, according to a secondary analysis of a large trial by Dr Stevo Julius, of the University of Michigan in Ann Arbor.

Each 10 beats per minute increase in baseline heart rate was associated with a relative 16% greater risk of cardiovascular mortality and morbidity (P<0.0001).

The relationship remained significant (P<0.0001) even among those patients who had their blood pressure controlled to less than 140/90 mm Hg (average 130/77 mm Hg).

Lowering of glucose, lipids, blood pressure decreases cardiovascular events, same is true now for lowering the heart rate. Remember the formula of 80: Keep your lower blood pressure, resting pulse, bad cholestarol, fasting sugar and abdominal circumference all lower than 80.

Dr KK Aggarwal
Padma Shri Awardee and Chief Editor

 

Photo Feature(From file)

Science Behind Miracles

Our country is rich in cultural heritage and subsequent myths and beliefs. Some crooks take advantage of that and fool us with so called miracles and treatment methods. Heart Care foundation of India to eradicate such myths by explaining the science behind such miracles. 

Dr k k Aggarwal

International Medical Science Academy Update (IMSA): Practice Changing Updates

Weight loss and increased physical activity can lead to sustained improvement in liver enzymes, histology, serum insulin levels, and quality of life in patients with NASH.

  1. Hickman IJ, Jonsson JR, Prins JB, et al. Modest weight loss and physical activity in overweight patients with chronic liver disease results in sustained improvements in alanine aminotransferase, fasting insulin, and quality of life. Gut 2004;53:413.

  2. Dixon JB, Bhathal PS, Hughes NR, et al. Nonalcoholic fatty liver disease: improvement in liver histological analysis with weight loss. Hepatology 2004;39:1647.

  3. Petersen KF, Dufour S, Befroy D, et al. Reversal of nonalcoholic hepatic steatosis, hepatic insulin resistance, and hyperglycemia by moderate weight reduction in patients with type 2 diabetes. Diabetes 2005;54:603.

  4. Promrat K, Kleiner DE, Niemeier HM, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology 2010;51:121.

 

News and Views (Dr Brahm and Monica Vasudeva)

1. Vitamin A boosts response to HCV treatment

Early and sustained virologic responses to standard treatment for hepatitis C virus (HCV) infection were markedly improved when patients also received high doses of vitamin A. (Dr Shuichi Sato, Shimane University, Izumo, Japan)

2. Bar codes cut down medication errors

Use of bar codes for medication administration cut medication errors not related to timing of administration by 41% in a large hospital. In a review of 14,041 observed medication administrations and 3,082 order transcriptions, observers noted 776 nontiming errors in medication administration on units that did not use the bar code system (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate); (Dr Eric G. Poon, Brigham and Women’s Hospital, Boston)

3. Ventricular mass linked to renal problems

In men with high cardiovascular risk, increased left ventricular mass appears to be a sign of worsening kidney function. Left ventricular hypertrophy of at least moderate severity was associated with significantly increased risks of severe chronic kidney disease, hemodialysis, or a doubling in creatinine. (Dr Costas Tsioufis, of the Washington VA Medical Center and Georgetown University). For each 42 g/m2 increase in the left ventricular mass index, there was an elevation of risk of 45.7% for the doubling of creatinine, 51.9% for decline of glomerular filtration rate below 30 mL/min/1.73 m2, and 58.3% for the initiation of hemodialysis.

4. Stereotactic surgery beneficial in pancreatic cancer

Stereotactic radiosurgery may be an alternative for patients with locally advanced pancreatic cancer that is traditionally unresectable. Patients treated with the technology, which delivers beams of concentrated radiation to tumors via "synchrony," had a local tumor control rate of about 90%. (Dr Mukund Didolkar, of Sinai Hospital in Baltimore)

Mnemonic of the Day Varesh Nagrath: Criteria for diagnosis of SLE (systemic lupus erythematosus)

4 or more criteria in history: ROSHANII (suffers from) MDP
Renal disorder
Oral ulcer
Serositis
Hematologic disorder
Arthritis
Neurological disorder
Immunologic disorder (ANA)
Immunological disorders (dsDNA /Anticardiolipin /Sm)
Malar rash
Discoid rash
Photosenstivity

Quote of the Day

"There are always three speeches, for every one you actually gave. The one you practiced, the one you gave, and the one you wish you gave." Dale Carnegie

Question of the Day: Dr Shabina Ahmed

When do you suspect growth hormone deficiency?
Think of growth hormone deficiency in the following situations:

(a) Stature (height) is < 3rd centile. Height velocity progressive shortening (Velocity < 4cm/year)
(b) Skeletal age under chronological age
(c) Micropenis and cryptorchidism
(d) Relative obesity and increased skin fold thickness
(e) Delayed dentition

Stupid Question: (drsooneita@gmail.com)

You are smoking a cigarette and a cute woman in your office asks...
Stupid Question: Oh, so you smoke.
Answer: Gosh, it's a miracle ……… it was a piece of chalk and now it's in flames!!!

eMedinewS Try this it Works: Preventing aspiration

Patients on mechanical ventilation are at risk for gastric aspiration if kept in a supine position for too long. Maintaining such patients in a semirecumbent position to reduce gastric aspiration can benefit.

International Vaccines recommendations

Tuberculosis: Vaccination sometimes recommended 3 months before travel

Dr Good Dr Bad

Situation: An infant was found to have high blood sugar
Dr Bad: He can not have diabetes
Dr Good: It can be diabetes
Lesson: Diabetes can occur in infants as well as in older children.

Make Sure

Situation: Situation: A 26–year–old pregnant woman complaining of lower abdominal pain, burning during urination and increased vaginal discharge is prescribed ofloxacin.

Reaction: Oh my God! Why did you give flouroquinolone! They are contraindicated during pregnancy. You should have given a safe and effective antibiotic like azithromycin.

Lesson: Make sure to remember that 1 g single–dose regimen of azithromycin is safe and effective in pregnant woman.

IMADNB Joke of the Day (Dr. Tarun Gupta)

BREVITY

The best illustration of the value of brief speech reckoned in dollars was given by Mark Twain. His story was that when he had listened for five minutes to the preacher telling of the heathen, he wept, and was going to contribute fifty dollars, after ten minutes more of the sermon, he reduced the amount of his prospective contribution to twenty–five dollars, after half an hour more of eloquence, he cut the sum to five dollars. At the end of an hour of oratory when the plate was passed, he stole two dollars.

Formulae in Rural Practice: RR Interval - Heart Rate

RR interval is the duration of ventricular cardiac cycle (an indicator of ventricular rate)
QT = Should be less than half of RR

Milestones in Diabetology

Celsus (1st century AD) writes an encyclopedia on medicine that includes a description of a condition likely to be diabetes, calls it "excessive pouring out of urine" and causing �emaciation and danger."

Lab Test (Dr Arpan Gandhi and Dr Navin Dang)

Protein electrophoresis

Protein electrophoresis or Immunoelectrophoresis) is a method of analysing a mixture of proteins by means of gel electrophoresis, mainly in blood serum. Abnormal bands (spikes) are seen in monoclonal gammopathy of undetermined significance and multiple myeloma etc.

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name

Indication

Approval Date

Bimatoprost Opthalmic solution 0.03%

For the treatment of hypotrichosis of the eyelashes by increasing their growth including length, thickness and darkness.

30.03.09

IMA Election Update

The IMA National President, Secretary and other office bearers' elections are due to be announced by 1st july. The present crisis in Medical Council of India has already postponed its schedule 6th May working committee to 6th June. Will the IMA elections be held in time.

MCI Update

Ketan Desai suspended from B J Medical College


MCI President Dr Ketan Desai, being a public servent, has been suspended from the post of Head of Department of Urology at B J Medical College, said Principal Secretary Health Rajesh Kishore. The government did not accept Desai's resignation. Dr Desai had sent his resignation by post a couple of days ago to the Dean of B J Medical College, which he had forwarded to the state government.

 

Public Forum (Press Release for use by the newspapers)

Porcine Whipworm Ova Safe for Treatment of IBD

Orally ingested ova of Trichuris suis, the porcine whipworm, has been found to be active in an open-label study of Crohn's disease, and in a small scale, placebo-controlled trial in patients with ulcerative colitis said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Inflammatory bowel diseases are diseases of the affluent society. Many trials have shown that infection with parasitic worms is protective. Intestinal helminthes induce Th2 cytokine release and specifically down regulate Th1 responsiveness

Administering eggs from the porcine whipworm Trichuris suis to patients with Crohn's disease and ulcerative colitis is a safe and possibly effective treatment for inflammatory bowel disease according to a report published in the American Journal of Gastroenterology. In the open-label trial, 29 patients with refractory disease, and a Crohn's disease activity index (CDAI) of 220 to 450, ingested 2,500 T. suis ova in a beverage every three weeks for 24 weeks. By week 12, 22 patients (75.9%) experienced a decrease in CDAI of more than 100 points, or had a CDAI of less than 150. Another 18 patients (62.1%) were in remission. (Four patients withdrew early because of disease activity or pregnancy.) They observed no adverse effects or complications. In the treatment a single dose of 2500 live Trichuris suis eggs are given orally.

Readers Responses

  1. Dear Sir, At the very outset I congratulate you for being conferred this prestigious award, which I strongly feel should have come your way long back. Secondly, I compliment you on your effort to bring all of the awardees together and form a think tank. Thanks and regards: Dr Ashok K Vaid, MD,DM, Medical Oncologist.

  2. It is surprising that out of top 150 members of the Medical Council of India till now not even a single member has come out openly in support or against the alleged corruption charges against the Council. If none of them will come forward, it will be understood that every member of the council is a part of corruption unless proved otherwise. (Dr V Gawhi)
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eMedinewS–Padma Con 2010

Will be organized at
Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

 
 

eMedinewS–revisiting 2010

The second eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, cultural hungama and live webcast. Suggestions are invited .

 

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